Technical Field
The present disclosure relates to an implant suitable for use in the prevention and/or treatment of hernias that may occur in the area of a stoma, particularly one formed in the abdominal wall.
Description of Related Art
Stomas are openings formed in a wall, for example the abdominal wall, for joining a hollow organ, for example the intestine, to the skin. Such an operation proves necessary, for example in cases of cancer of the rectum or Crohn's disease, to create an artificial anus for example, during which operation the diseased part of the intestine is resected and the healthy intestine is exteriorized at the skin. In this case, the stoma is formed in the abdominal wall. FIG. 1 is a schematic illustration of the human digestive tract. This diagram shows the stomach 1, the small intestine 2 and the colon 3. The broken lines represent the part 3a of the colon that is diseased and has been removed during the surgical procedure. The healthy part 3b of the colon now opens to the outside at the stoma 4 formed in the abdominal wall. Depending on the extent of the diseased part of the colon, the stomas can be formed in the area of the ileum 5 (ileostomy) or of the colon (colostomy), as shown in FIG. 1. Stomas can also be formed in the area of the ureters (ureterostomy).
After operations of this kind, hernias may develop around the stoma, that is to say in the area of the peristomal wall. A weakening of the wall around the stoma may therefore result in the appearance of a parastomal hernia. To treat these parastomal hernias, prostheses are implanted that are designed to strengthen the abdominal wall inside the patient, in the area of the stoma. The implantation of these prostheses can be intraperitoneal, that is to say within the actual abdominal wall, or retroperitoneal, resting against the abdominal wall.
Prostheses for treating parastomal hernias have been described in the document WO2004/071349. However, these prostheses are not entirely satisfactory, particularly since they are not adapted to all types of stomas that are formed, particularly indirect stomas.
The reason is that, for example in the case of the colon, several stoma configurations can be formed: the direct stoma, as shown in FIG. 2, in which the colon 3 issuing from the abdominal cavity 8 is perpendicular to the abdominal wall 7 and hence to the skin 6 prior to its exteriorization, or the indirect stoma, as shown in FIG. 3, in which the colon 3 is caused to form a bend within the abdominal cavity 8 prior to its exteriorization, the colon thus having a part 3c parallel to the abdominal wall 7. The indirect stoma avoids a situation where the internal part of the colon in the area of the stoma becomes invaginated and exteriorizes.
There is therefore a need for a parastomal prosthesis able to protect the intestine and hollow organs and to effectively strengthen the abdominal wall regardless of the type of stoma that has been formed.